Iom Report Impact on Nursing
Difference Between Nurses at the Associate vs. Baccalaureate Degree Level To this day there are three types of programs that exist to allow an individual to practice as an RN: the diploma, the Associate degree, and the Baccalaureate degree. The diploma route is a hospital based program that prepares an individual to sit for the NCLEX-RN.
It is usually a two to three year program. It prepares the student for nursing jobs for delivering direct patient care in the hospital or other inpatient setting.
The associate route RN is typically a two-year program that focuses on teaching the student technical nursing skills with basic education requirements in math, science, and English. It prepares the student for entry-level nursing jobs in hospitals and inpatient facilities. The baccalaureate route RN holds the higher level of education in nursing. It is achieved through a more rigorous educational study through research and evidence-based practices that prepares them for leadership and management positions.
In comparing the associate degree nurse vs. he baccalaureate degree nurse, in order to increase patient safety, the associate degree nurse should attain their baccalaureate degree for standardization in with our continually changing health care systems. In looking back in history, the associate degree of nursing (ADN) was designed by Mildred Montag in 1952 to help the nursing shortage as a collegiate alternative (Creasia and Friberg, 2011, p. 27). It started as a pilot project at seven sites that has now grown to be very successful and desirable when compared to the 4-year baccalaureate route.
The 2-year associate degree route is sought out more for its cost effectiveness while achieving the same goal of being able to take the NCLEX-RN for licensure.
Especially as studies from the Committee of the American Society of Nursing Service Administration noted that they saw no difference among beginning practitioners from BSN, ADN, or diploma programs (Schank and Stollenwerk, 1988, p. 254). The key word here is beginning practitioner, there is no difference between the performances of the two.
However, if an individual desires to advance in their nursing career, the associate degree separates the baccalaureate degree holding RN from a higher position and pay for example in a managerial or supervisory role. The baccalaureate degree was intended by the ANA to be the entry point into professional nursing practice (ANA, 1965).
Those who choose the BSN route are prepared to practice nursing in beginning leadership positions. In order to take on a leadership role, the baccalaureate holding nurse needs to have a more in depth education with skills in communication, leadership, and critical thinking.
The inclusion of public health in the BSN program requires a nurse to be adequately knowledgeable to educate beyond the individual onto the communities and population. Not only is the BSN nurse able to communicate beyond the individual but also better able to collaborate with those holding higher educational degrees as well. Being able to communicate clearly the knowledge learned, through critical thinking based on evidence-based practices is what differentiates an associate degree from a baccalaureate degree nurse. Because of these qualities, it also affords them the ability to take on leadership roles.
Higher education enables BSN nurses to go outside the small circle of practice. Studies have shown that patient outcomes can be attributed to higher levels of nursing education. More knowledge enhances the nurses’ concept of nursing as a profession to better adapt to a continually changing health care environment. More knowledge enhances the nurses’ concept of nursing as a profession to better adapt to a continually changing health care environment and by having experience in research of evidence-based practices gives the nurse a firm foundation. Their knowledge is broader to help promote positive patient outcomes (Spencer, 2008, p.
08). In one study they found a “10% increase in proportion of BSN nurses was associated with a 5% decrease in likelihood of death” (Ridley, 2008, p. 152). One aspect of the BSN student that the ADN student does not acquire is delving into evidence based practices. The BSN nurse, therefore, is transitioned from the basic clinical aspects of nursing from the individual patient onto a broader spectrum.
Research enables the RN to become more reflective by evaluating past clinical experiences, honing in on critical thinking skills to help better understand our changing healthcare environment.
In evaluating the table from the studies of the Examples of Activities included in the 1999 RN Practice Analysis with Average Frequencies of Performance (Smith, 2002, p. 493), I found that the tasks that required more critical thinking and collaboration with higher disciplinary teams, were slightly higher amongst the BSN group. The average of 3. 73(BSN) vs. 3.
40 (ADN) would consult with other health care providers about client care, average 3. 15 (BSN) vs. 2. 92 (ADN) would act as the clients advocate, and 0. 85 (BSN) vs. 0.
5 (ADN) would plan and develop a health promotion program based on a community assessment (Smith, 2002, p. 493). Many of the activities shown on the table reflect that there were not many differences among the ADN and BSN nurse. The BSN nurse has better communication skills would collaborate with other disciplinary teams and act more often as a patient advocate. Because the BSN nurse also has a more rich understanding of evidence based practices and research, he/she would be more likely assist in developing a health promotion program.
In conclusion, even though it is more cost efficient in obtaining an associates degree or even diploma to qualify for RN licensure, the baccalaureate degree should be the standard goal. Our health care system is continually changing, it is the responsibility of the nurse to also strive to grow with our environmental changes by achieving higher education. Not only does the BSN nurse qualify for higher positions in the health care system, but it also produces better patient outcomes. References American Nurses Association. (1965). A position paper.
New York, NY: American Nurses Association; 1965. Creasia, J.
L. , & Friberg, E. (2011).
Conceptual Foundations: The Bridge to Professional Nursing Practice, 5th Edition. , 2011. Pageburst Online. Web. 21 February 2013 .
Ridley, R. T. (2008). The Relationship Between Nurse Education Level and Patient Safety: An Integrative Review. Journal of Nursing Education, 47, 149-156.
Retrieved from http://ehis. ebscohost. com. library. gcu.
edu:2048/eds/pdfviewer/pdfviewer? sid=e2ae0a10-62a7-418b-ab46-32ad87faa068%40sessionmgr113&vid=4&hid=3 Schank, M. J. , & Stollenwerk, R. (1988, June 1, 1988). The Leadership/Management Role: A Differentiating Factor for ADN/BSN Programs?
Journal of Nursing Education, 27, 253-257.
Retrieved from http://ehis. ebscohost. com. library. gcu.
edu:2048/eds/detail? sid=f2a65c9b-fb18-4dd4-ba84-717a1f32bb14%40sessionmgr4&vid=5&hid=102&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#db=rzh&AN=1988078948 Smith, J. E. (2002). Analysis of Differences in Entry-Level RN Practice by Educational Preparation. Journal of Nursing Education, 41, 491-494. Retrieved from http://ehis.
ebscohost. com. library. gcu. edu:2048/eds/pdfviewer/pdfviewer? sid=a9aecc8d-204c-4c13-b26c-12ce8475eea0%40sessionmgr111&vid=4&hid=4